Patient survey report 2011 Survey of adult inpatients 2011 The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
The national survey of adult inpatients in the NHS 2011 was designed, developed and co-ordinated by the Co-ordination Centre for the NHS Patient Survey Programme at Picker Institute Europe.
National NHS patient survey programme Survey of adult inpatients 2011 Re-design of the benchmark reports This is a new style of benchmark report, replacing the previous reports produced for the national surveys which contained scores out of 100. We have designed this report using feedback from people who use the data. The data contained here uses the same scoring system as before but presents the data as a score out of 10, and displays trusts' performance in a different way to the previous reports, using a more robust statistical technique. The scores and groupings now match those presented under the organisational search tool available on the CQC website http://www.cqc.org.uk/surveys/inpatient. The Care Quality Commission The Care Quality Commission is the independent regulator of health care and adult social care services in England. We also protect the interests of people whose rights are restricted under the Mental Health Act. Whether services are provided by the NHS, local authorities or by private or voluntary organisations, we focus on: Identifying risks to the quality and safety of people s care Acting swiftly to help eliminate poor-quality care. Making sure care is centered on people s needs and protects their rights. Survey of adult inpatients 2011 To improve the quality of services that the NHS delivers, it is important to understand what patients think about their care and treatment. One way of doing this is by asking patients who have recently used their local health services to tell us about their experiences. The survey results are primarily intended to be used by NHS trusts to help them improve their performance. We have included data from the survey in the Quality and Risk Profiles for providers, which contributes to our assessment of compliance with the essential standards of quality and safety set by the government. The Department of Health will also use the results for performance assessment, improvement and regulatory purposes. The ninth survey of adult inpatients involved 161 1 acute and specialist NHS trusts. We received responses from more than 70,000 patients, a response rate of 53%. Patients were eligible for the survey if they were aged 16 years or older, had at least one overnight stay during June, July or August 2011 2 (sampling month chosen by the trust) and were not admitted to maternity or psychiatric units. Fieldwork took place between October 2011 and January 2012. Similar surveys of adult inpatients were also carried out in 2002, 2004, 2005, 2006, 2007, 2008, 2009 and 2010. They are part of a wider programme of NHS patient surveys, which covers a range of topics including mental health services and outpatient services. To find out more about our programme and for the results from previous surveys, please see the links contained in the further information section. The data in this report This report provides the results of the ninth survey of adult inpatients in NHS trusts in England, and shows how a trust scored for each question in the survey, compared against the range of results from all other trusts that took part in the survey. It is designed to help to understand the performance of individual trusts, and to identify areas for improvement. Results displayed in this report are a graphical representation of the results displayed for the public 1 Although respondents from 162 trusts took part in the survey, these results are based on 161. One trust was excluded from the publication due to a sampling error. 2 Some trusts who could not achieve the required sample size sampled back further. 1
under the organisational search facility on the CQC website. The same data is shown on the website in a more simplified way, identifying whether a trust performed better or worse or about the same as the majority of other trusts for each question. You can also find on the CQC website the national overall results for the 2011 survey compared to those from 2010, alongside a national summary highlighting the key issues. Interpreting the report The report provides a score for each question, and a score for each section. The scores for each question are grouped according to the sections of the questionnaire as completed by respondents. For example, the survey includes sections on the hospital and ward and care and treatment, amongst others. At the end of the report you will find tables containing the data used for the graphs and background information about the patients that responded. For each question in the survey, the individual responses were converted into scores on a scale of 0 to 10. A score of 10 represents the best possible response. Therefore, the higher the score for each question, the better the trust is performing. 3 It is not appropriate to score all questions within the questionnaire, this is because not all of the questions assess the trusts in any way, or they may be filter questions designed to filter out respondents to whom following questions do not apply. An example of a filter question would be Q51 During your stay in hospital, did you have an operation or procedure? The graphs in this report display the scores for this trust, compared with the full range of results from all other trusts that took part in the survey. Each bar represents the range of results for each question across all trusts. In the graphs, the bar is divided into three sections: If your trust score lies in the orange section of the graph, your trust result is about the same as most other trusts in the survey If your trust score lies in the red section of the graph, your trust result is worse compared with most other trusts in the survey If your trust score lies in the green section of the graph, your trust result is better compared with most other trusts in the survey. A black diamond represents the score for this trust. The black diamond (score) is not shown for questions answered by fewer than 30 people because the uncertainty around the result would be too great. The trust will also not have a section score for the corresponding section, this is because the section data is not comparable with other trusts, as it is made up of fewer questions. You may find that there is no red area, and/or no green area in the charts shown for some questions. This can occur in the analysis of the data and is an acceptable consequence of the statistical technique that is used. The size of the orange area is constructed by considering how different all trust scores are across the range, as well as the confidence we can have in that particular trust s score (by looking at the number of respondents to that question). In some cases, this will lead to such a wide margin of error that the expected range (the orange section) will be very wide, and hence will also cover the highest or lowest scoring trusts for that question. At the end of the report you will find tables containing the data used for the graphs and background 3 Trusts have differing profiles of patients. For example, one trust may have more male inpatients than another. This can potentially affect the results because people tend to answer questions in different ways, depending on certain characteristics. For example, older respondents tend to report more positive experiences than younger respondents, and women tend to report less positive experiences than men. This could potentially lead to a trust s results appearing better or worse than if they had a slightly different profile of patients. To account for this, we standardise the data. Results have been standardised by the age, sex and method of admission (emergency or elective) of respondents to ensure that no trust will appear better or worse than another because of its respondent profile. This helps to ensure that each trust s age-sex-admission type profile reflects the national age-sex-admission type distribution (based on all of the respondents to the survey). It therefore enables a more accurate comparison of results from trusts with different profiles of patients. 2
information about the patients that responded. PLEASE NOTE: As the reports have been re-designed, these groupings are different from those used in the previous style of benchmark report, which showed the top 20% and bottom 20% of scores. These groupings here are instead based on a statistical analysis involving the use of adjusted Z scores and winsorisation. More detail can be found in the technical report, details in the further information section below. Methodology The categories described above are based on a statistic called the 'expected range which is uniquely calculated for each trust for each question. This is the range within which we would expect a particular trust to score if it performed about the same as most other trusts in the survey. The range takes into account the number of respondents from each trust as well as the scores for all other trusts. This means that where a trust is performing better or worse than the majority of other trusts, this is likely to be a true reflection of all patients that have visited the trust, rather than being unique to those who responded to the survey. A technical document providing more detail about the methodology and the scoring applied to each question is available on our website (see further information section). Notes on specific questions Please note that a variety of acute trusts take part in this survey and not all questions are applicable to every trust. The section below details modifications to certain questions, in some cases this will apply to all trusts, in other cases only to applicable trusts. All trusts Q8: ( Overall, from the time you first talked to this health professional about being referred to a hospital, how long did you wait to be admitted to hospital? ) excludes patients who were not referred for a planned admission to hospital by a GP or health professional in England (i.e. their care was not bought or commissioned in England but in Northern Ireland, Scotland or Wales). This is because waiting time policies differ outside of England. All trusts Q60 and Q61: The information collected by Q60 ( On the day you left hospital, was your discharge delayed for any reason? ) and Q61 ( What was the main reason for the delay? ) are presented together to show whether a patient s discharge was delayed by reasons attributable to the hospital. The combined question in this report is labelled as Q61 and is worded as: Discharge delayed due to wait for medicines/to see doctor/for ambulance. All trusts Q62: Information from Q60 and Q61 has been used to score Q62 ( How long was the delay? ) to assess the length of a delay to discharge for reasons attributable to the hospital. Trusts with male and female patients Q14 and Q17: The information collected by Q14 ( When you were first admitted to a bed on a ward, did you share a sleeping area, for example a room or bay, with patients of the opposite sex? ) and Q17 ( After you moved to another ward (or wards), did you ever share a sleeping area, for example a room or bay, with patients of the opposite sex? ) are presented together to show whether the patient has ever shared a sleeping area with patients of the opposite sex. The combined question is numbered in this report as Q14 and has been reworded as Did you ever share a sleeping area with patients of the opposite sex? 4 5 4 Please note that the information based on Q14 cannot be compared to similar information collected in the 2002, 2004 and 2005 surveys. This is due to a change in the questions wording and because the results for 2006 onwards have excluded patients who have stayed in a critical care area, which almost always accommodates patients of both sexes. For further details, please see the technical document which shows the scores assigned to each question (available on our website). 5 Trusts providing services for women only have been excluded when calculating the national average for Q14 (Did you ever share a sleeping areas with patients of the opposite sex) and Q19 (Did you ever use the same bathroom or shower area as patients of the opposite sex?). 3
Trusts with female patients only Q14 and Q19: If your trust offers services to women only, a trust score for Q14 ("Did you ever share a sleeping area with patients of the opposite sex?") and Q19 ("While staying in hospital, did you ever use the same bathroom or shower area as patients of the opposite sex?") is not shown. Trusts with no A&E department Q3-Q5 (The Accident and Emergency Department): The results to these questions are not shown for trusts that do not have an emergency department. For further more detailed information on how questions in the survey are scored please see the technical document available on our website. Further information The full national results are on the CQC website, together with an A to Z list to view the results for each trust (alongside the technical document outlining the methodology and the scoring applied to each question): www.cqc.org.uk/inpatientsurvey2011 The results for the adult inpatient surveys from 2002 to 2010 can be found at: www.nhssurveys.org/surveys/292 The 2002 survey of adult inpatient results (published by the Department of Health) can be found at: www.dh.gov.uk/en/publicationsandstatistics/publishedsurvey/ NationalsurveyofNHSpatients/Nationalsurveyinpatients/index.htm Full details of the methodology of the survey can be found at: www.nhssurveys.org/ More information on the programme of NHS patient surveys is available at: www.cqc.org.uk/public/reports-surveys-and-reviews/surveys More information on Quality and Risk Profiles (QRP) can be found at: www.cqc.org.uk/organisations-we-regulate/registered-services/quality-and-risk-profiles-qrps 4
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Section scores S1. The Emergency/A&E Department (answered by emergency patients only) S2. Waiting list and planned admissions (answered by those referred to hospital) S3. Waiting to get to a bed on a ward S4. The hospital and ward S5. Doctors S6. Nurses S7. Care and treatment S8. Operations and procedures (answered by patients who had an operation or procedure) S9. Leaving hospital S10. Overall views and experiences Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 5
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust The Emergency/A&E Department (answered by emergency patients only) Q3. While you were in the A&E Department, how much information about your condition or treatment was given to you? Q4. Were you given enough privacy when being examined or treated in the A&E Department? Q5. Following arrival at the hospital, how long did you wait before being admitted to a bed on a ward? Waiting list and planned admissions (answered by those referred to hospital) Q8. Overall, from the time you first talked to a health professional about being referred to hospital, how long did you wait to be admitted to hospital? Q9. How do you feel about the length of time you were on the waiting list? Q10. Were you given a choice of admission dates? Q11. Was your admission date changed by the hospital? Waiting to get to a bed on a ward Q12. From the time you arrived at the hospital, did you feel that you had to wait a long time to get to a bed on a ward? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 6
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust The hospital and ward Q14. Did you ever share a sleeping area with patients of the opposite sex? Q19. Did you ever use the same bathroom or shower area as patients of the opposite sex? Q20. Were you ever bothered by noise at night from other patients? Q21. Were you ever bothered by noise at night from hospital staff? Q22. In your opinion, how clean was the hospital room or ward that you were in? Q23. How clean were the toilets and bathrooms that you used in hospital? Q24. Did you feel threatened during your stay in hospital by other patients or visitors? Q25. Did you have somewhere to keep your personal belongings whilst on the ward? Q26. Did you see any posters or leaflets on the ward asking patients and visitors to wash their hands or to use hand-wash gels? Q27. Were hand-wash gels available for patients and visitors to use? Q28. How would you rate the hospital food? Q29. Were you offered a choice of food? Q30. Did you get enough help from staff to eat your meals? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 7
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Doctors Q31. When you had important questions to ask a doctor, did you get answers that you could understand? Q32. Did you have confidence and trust in the doctors treating you? Q33. Did doctors talk in front of you as if you weren't there? Q34. As far as you know, did doctors wash or clean their hands between touching patients? Nurses Q35. When you had important questions to ask a nurse, did you get answers that you could understand? Q36. Did you have confidence and trust in the nurses treating you? Q37. Did nurses talk in front of you as if you weren't there? Q38. In your opinion, were there enough nurses on duty to care for you in hospital? Q39. As far as you know, did nurses wash or clean their hands between touching patients? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 8
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Care and treatment Q40. Did a member of staff say one thing and another say something different? Q41. Were you involved as much as you wanted to be in decisions about your care and treatment? Q42. How much information about your condition or treatment was given to you? Q43. Did your family or someone close to you have enough opportunity to speak to a doctor? Q44. Did you find someone on the hospital staff to talk to about your worries and fears? Q45. Do you feel you got enough emotional support from hospital staff during your stay? Q46. Were you given enough privacy when discussing your condition or treatment? Q47. Were you given enough privacy when being examined or treated? Q49. Do you think the hospital staff did everything they could to help control your pain? Q50. After you used the call button, how long did it usually take before you got help? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 9
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Operations and procedures (answered by patients who had an operation or procedure) Q52. Did a member of staff explain the risks and benefits of the operation or procedure? Q53. Did a member of staff explain what would be done during the operation or procedure? Q54. Did a member of staff answer your questions about the operation or procedure? Q55. Were you told how you could expect to feel after you had the operation or procedure? Q57. Did the anaesthetist or another member of staff explain how he or she would put you to sleep or control your pain? Q58. Afterwards, did a member of staff explain how the operation or procedure had gone? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 10
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Leaving hospital Q59. Did you feel you were involved in decisions about your discharge from hospital? Q61. Discharge delayed due to wait for medicines/to see doctor/for ambulance. Q62. How long was the delay? Q63. Before you left hospital, were you given any written or printed information about what you should or should not do after leaving hospital? Q64. Did a member of staff explain the purpose of the medicines you were to take at home in a way you could understand? Q65. Did a member of staff tell you about medication side effects to watch for when you went home? Q66. Were you told how to take your medication in a way you could understand? Q67. Were you given clear written or printed information about your medicines? Q68. Did a member of staff tell you about any danger signals you should watch for after you went home? Q69. Did the doctors or nurses give your family or someone close to you all the information they needed to care for you? Q70. Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital? Q71. Did you receive copies of letters sent between hospital doctors and your family doctor (GP)? Q72. Were the letters written in a way that you could understand? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 11
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Overall views and experiences Q73. Overall, did you feel you were treated with respect and dignity while you were in the hospital? Q74. How would you rate how well the doctors and nurses worked together? Q75. Overall, how would you rate the care you received? Q76. During your hospital stay, were you ever asked to give your views on the quality of your care? Q77. While in hospital, did you ever see any posters or leaflets explaining how to complain about the care you received? Best performing trusts This trust About the same Worst performing trusts This trust's results are not shown if there were fewer than 30 respondents. 12
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust The Emergency/A&E Department (answered by emergency patients only) S1 Section score 7.3 6.0 9.3 Q3 Q4 Q5 While you were in the A&E Department, how much information about your condition or treatment was given to you? Were you given enough privacy when being examined or treated in the A&E Department? Following arrival at the hospital, how long did you wait before being admitted to a bed on a ward? 8.0 7.0 9.8 198 8.2 7.6 9.8 205 5.6 3.4 8.7 198 Waiting list and planned admissions (answered by those referred to hospital) S2 Section score 6.7 5.7 7.6 Q8 Overall, from the time you first talked to a health professional about being referred to hospital, how long did you wait to be admitted to hospital? 6.1 4.6 8.9 230 Q9 How do you feel about the length of time you were on the waiting list? 8.7 6.6 9.4 252 Q10 Were you given a choice of admission dates? 2.6 1.2 4.9 243 Q11 Was your admission date changed by the hospital? 9.5 8.4 9.8 248 Waiting to get to a bed on a ward S3 Section score 8.0 5.6 9.7 Q12 From the time you arrived at the hospital, did you feel that you had to wait a long time to get to a bed on a ward? 8.0 5.6 9.7 479 13
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust The hospital and ward S4 Section score 8.2 7.5 8.9 Q14 Did you ever share a sleeping area with patients of the opposite sex? 9.2 7.3 9.9 389 Q19 Did you ever use the same bathroom or shower area as patients of the opposite sex? 8.2 6.4 9.8 428 Q20 Were you ever bothered by noise at night from other patients? 5.9 4.7 8.6 476 Q21 Were you ever bothered by noise at night from hospital staff? 7.9 6.9 9.4 478 Q22 In your opinion, how clean was the hospital room or ward that you were in? 8.8 7.8 9.7 480 Q23 How clean were the toilets and bathrooms that you used in hospital? 8.5 7.3 9.5 461 Q24 Did you feel threatened during your stay in hospital by other patients or visitors? Q25 Did you have somewhere to keep your personal belongings whilst on the ward? Q26 Did you see any posters or leaflets on the ward asking patients and visitors to wash their hands or to use hand-wash gels? 9.7 9.1 10.0 481 6.8 5.5 8.8 419 9.3 8.6 9.9 425 Q27 Were hand-wash gels available for patients and visitors to use? 9.5 9.2 10.0 453 Q28 How would you rate the hospital food? 6.1 4.1 7.8 458 Q29 Were you offered a choice of food? 8.5 7.7 9.7 475 Q30 Did you get enough help from staff to eat your meals? 7.8 5.8 9.1 110 Doctors S5 Section score 8.5 7.8 9.5 Q31 When you had important questions to ask a doctor, did you get answers that you could understand? 8.0 7.2 9.3 426 Q32 Did you have confidence and trust in the doctors treating you? 8.9 8.1 9.7 483 Q33 Did doctors talk in front of you as if you weren't there? 8.1 7.1 9.5 481 Q34 As far as you know, did doctors wash or clean their hands between touching patients? 9.1 7.9 9.7 266 14
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Nurses S6 Section score 8.4 7.3 9.4 Q35 When you had important questions to ask a nurse, did you get answers that you could understand? 7.9 6.9 9.2 410 Q36 Did you have confidence and trust in the nurses treating you? 8.6 7.5 9.5 485 Q37 Did nurses talk in front of you as if you weren't there? 8.6 7.2 9.7 485 Q38 In your opinion, were there enough nurses on duty to care for you in hospital? 7.7 6.0 9.1 482 Q39 As far as you know, did nurses wash or clean their hands between touching patients? Care and treatment 9.0 7.8 9.7 330 S7 Section score 7.5 6.6 8.6 Q40 Did a member of staff say one thing and another say something different? 8.1 6.9 8.9 484 Q41 Were you involved as much as you wanted to be in decisions about your care and treatment? 7.1 5.9 8.6 478 Q42 How much information about your condition or treatment was given to you? 7.9 6.9 9.1 485 Q43 Did your family or someone close to you have enough opportunity to speak to a doctor? Q44 Did you find someone on the hospital staff to talk to about your worries and fears? Q45 Do you feel you got enough emotional support from hospital staff during your stay? 6.6 5.0 8.2 306 5.8 4.3 7.9 269 7.3 5.8 8.7 303 Q46 Were you given enough privacy when discussing your condition or treatment? 8.2 7.4 9.2 481 Q47 Were you given enough privacy when being examined or treated? 9.3 9.0 9.9 482 Q49 Do you think the hospital staff did everything they could to help control your pain? Q50 After you used the call button, how long did it usually take before you got help? 8.3 7.1 9.4 307 6.4 5.0 7.5 273 15
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Operations and procedures (answered by patients who had an operation or procedure) S8 Section score 8.4 7.5 9.0 Q52 Did a member of staff explain the risks and benefits of the operation or procedure? Q53 Did a member of staff explain what would be done during the operation or procedure? Q54 Did a member of staff answer your questions about the operation or procedure? Q55 Were you told how you could expect to feel after you had the operation or procedure? Q57 Did the anaesthetist or another member of staff explain how he or she would put you to sleep or control your pain? Q58 Afterwards, did a member of staff explain how the operation or procedure had gone? 8.9 8.1 9.6 343 8.8 7.8 9.2 341 9.0 8.0 9.4 298 7.2 6.1 8.7 345 8.9 8.0 9.6 303 7.7 6.8 9.0 339 Leaving hospital S9 Section score 7.3 6.0 8.6 Q59 Did you feel you were involved in decisions about your discharge from hospital? 7.0 5.8 8.3 422 Q61 Discharge delayed due to wait for medicines/to see doctor/for ambulance. 7.1 4.7 8.2 459 Q62 How long was the delay? 8.2 6.3 9.2 457 Q63 Before you left hospital, were you given any written or printed information about what you should or should not do after leaving hospital? Q64 Did a member of staff explain the purpose of the medicines you were to take at home in a way you could understand? Q65 Did a member of staff tell you about medication side effects to watch for when you went home? 6.9 5.1 9.0 469 8.5 7.0 9.5 372 5.1 3.4 7.6 313 Q66 Were you told how to take your medication in a way you could understand? 8.5 6.9 9.6 329 Q67 Were you given clear written or printed information about your medicines? 7.8 6.4 9.0 401 Q68 Did a member of staff tell you about any danger signals you should watch for after you went home? Q69 Did the doctors or nurses give your family or someone close to you all the information they needed to care for you? Q70 Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital? Q71 Did you receive copies of letters sent between hospital doctors and your family doctor (GP)? 5.5 4.0 7.6 353 6.5 4.5 7.8 306 8.1 6.1 9.5 437 6.8 2.2 9.3 433 Q72 Were the letters written in a way that you could understand? 8.3 7.3 9.4 291 16
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Overall views and experiences S10 Section score 6.4 5.1 7.4 Q73 Overall, did you feel you were treated with respect and dignity while you were in the hospital? 8.9 7.9 9.7 473 Q74 How would you rate how well the doctors and nurses worked together? 7.9 6.6 9.2 473 Q75 Overall, how would you rate the care you received? 8.1 6.6 9.2 475 Q76 During your hospital stay, were you ever asked to give your views on the quality of your care? Q77 While in hospital, did you ever see any posters or leaflets explaining how to complain about the care you received? 1.6 0.4 4.1 423 5.3 2.6 6.7 339 17
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Background information The sample This trust All trusts Number of respondents 499 70863 Response Rate (percentage) 60 53 Demographic characteristics This trust All trusts Gender (percentage) (%) (%) Male 55 46 Female 45 54 Age group (percentage) (%) (%) Aged 35 and younger 3 8 Aged 36-50 6 13 Aged 51-65 22 25 Aged 66 and older 69 53 Ethnic group (percentage) (%) (%) White 94 90 Multiple ethnic group 1 1 Asian or Asian British 0 3 Black or Black British 0 2 Arab or other ethnic group 0 0 Not known 5 5 18